Irritable bowel syndrome: The role of psychosocial factors

The irritable bowel syndrome (IBS) is a very common disorder of intestinal function characterized by variable symptoms of abdominal pain, diarrhea, constipation and bloating. The spectrum of severity ranges from mild symptoms, not worthy of clinical attention, to intense and continuous symptoms associated with impaired health-related quality of life and high health care use. Psychosocial disturbance is commonly found among patients with irritable bowel, but until recently, its precise role in the disorder was uncertain. The data now suggest that irritable bowel is not a psychiatric disorder per se, but psychosocial factors including life stress, psychiatric comorbidity and abnormal illness behavior, among others, influence how the illness is experienced and acted upon. Patients with mild symptoms usually respond to education, reassurance, dietary modification and, when needed, antimotility agents. However, patients with more severe symptoms, who usually have greater psychosocial disturbance, will also require behavioral interventions, and possibly psychopharmacological agents. In sum, a graduated, multicomponent plan of care that includes dietary, behavioral and pharmacological treatments is recommended.     

Suppression of alcohol and saccharin preference in rats by a novel Ca2+ channel inhibitor,Goe 5438

The effect of the novel 1,4-dihydronaphthyridine Ca²⁺ channel inhibitor Goe 5438 (CI-951) on voluntary ethanol consumption was examined in selectively bred alcohol-preferring (P) rats in a free choice two bottle preference test versus water. Intraperitoneally injected Goe 5438 dose-dependently (5, 10 or 20 µmol/kg, twice daily) inhibited ethanol and increased water intake over the 24 h period (injection day). The drug decreased ethanol preference, originally above 90%, by 6%, 19% and 45% at respective doses, on the injection day. That inhibitory effect of the highest dose of Goe 5438 on ethanol preference remained significant also on days 2 and 3 after injections (–51% and –18%, respectively). Goe 5438, in the highest dose, also tended to decrease granulated chow consumption during the injection day only. To further test whether the inhibition of ethanol preference is secondary to decrease in reinforcing properties of ethanol and not due to interference with satiety mechanisms, we compared the effect of two higher doses (10 and 20 µmol/kg, intraperitoneally, twice daily) of Goe 5438 on spontaneous preference for a non-caloric 0.04% saccharin solution in Sprague-Dawley rats. We observed a dose-dependent suppression of preference (by 44% and 58%, respectively) during the injection day, but not the subsequent 24 h period. However, Goe 5438 also significantly alleviated food pellet intake on the injection day. In conclusion, Goe 5438 produces potent and long-lasting inhibition of voluntary ethanol consumption, which may be secondary to attenuation of reinforcing properties of ethanol. Additionally, this particular Ca²⁺ channel inhibitor appears to have mild anorectic properties which may be conducive to acute suppression of alcohol intake.     

精神分裂症患者6～11岁子女行为问题及相关因素对照研究

目的探讨精神分裂症患者6~11岁子女行为问题及相关因素。方法对山东省11所精神病医院(科)1999年6月~2000年6月间住院,符合中国精神疾病分类方案与诊断标准第2版修订本精神分裂症诊断的患者6~11岁子女(研究组)217名及正常人群子女(对照组)191名,采用自编心理卫生相关问题调查表(包括50个项目),Achenback儿童行为问题问卷(CBCL),进行登门调查,对照研究。结果研究组男、女童CBCL总分为(10.05±7.83)及(11.26±14.07),差异无显著性(P>0.05),但男女童研究组均高于对照组,差异极显著(P<0.00)。CBCL因子得分及家庭环境、教养情况,研究组与对照组比较,差异有显著性。结论精神分裂症患者6~11岁子女行为问题较多,受生物、心理、社会等多方面因素影响。     

老年人健康行为与心理健康关系的调查

目的探讨老年人的健康行为与心理健康之间的关系。方法采用候玉波等编制的健康行为量表和症状自评量表（SCL-90）对300名老年人进行测试,并进行相关分析。结果不同年龄和文化程度老年人在健康行为与心理健康方面有显著性差异（P〈0.05）;参与活动与心理健康水平呈显著正相关（P〈0.05）;心理应激、不良生活习惯与心理健康呈显著负相关（P〈0.05）。结论积极参与各项活动、减少各种心理应激和建立良好的生活习惯有利于提高老年人的心理健康水平。     

Comparison of transfer and distribution of technetium and rhenium in radish plants from nutrient solution

Tracer experiments were carried out to compare the plant uptake behavior of Tc and Re from nutrient solutions. Radish plants, transplanted to nutrient solution including various tracers, showed the same uptake and distribution of ^95mTc and ¹⁸³Re. The trend was the same when the ⁹⁹Tc and stable-Re concentrations were increased in nutrient solution. The behavior of other elements was different from that of Tc and Re. These findings suggest the possible use of Re as the chemical analogue of Tc in soil solution to plant uptake experiments.     

胃类癌生物学行为及与预后关系的临床研究

目的分析胃类癌特有的生物学行为与肿瘤预后之间的关系。方法总结1964年1月至2005年1月间收治的26例经手术切除、病理证实的胃类癌病例资料,对其肿瘤大小、胃壁侵犯深度、区域淋巴结转移、肝转移、术后辅助化疗和5年生存率进行分析。结果本组患者平均年龄58岁。其中18例(69.2%)肿瘤侵犯胃浆膜;12例(46.2%)有区域淋巴结转移;10例(38.5%)术后接受辅助化疗;14例(53.8%)在随访中出现肝转移。肿瘤大小与胃壁侵犯深度、区域淋巴结转移和肝转移的发生及5年生存率无关(P>0.05)。生存分析提示浆膜浸润、淋巴结转移和肝转移影响生存时间(P<0.05)。有浆膜浸润、淋巴结转移和肝转移的患者5年生存率分别为16.7%、16.7%和0,预后较差;化疗与否5年生存率比较,差异无统计学意义(P<0.05)。结论胃类癌术后辅助化疗并无益处,其预后与肿瘤的浸润深度、淋巴结转移和肝转移有关。     

Characteristics of apathy in Parkinson's disease.

The objective of this study was to use the Lille Apathy Rating Scale to assess apathy in a large population of Parkinson's disease (PD) patients and identify several different apathy profiles. One hundred fifty-nine patients with probable PD and 58 healthy controls participated in the study. Apathy was assessed using the Lille Apathy Rating Scale. Motor, cognitive, and depressive symptoms were rated on standardized scales. Data were analyzed using linear regression and multivariate analyses of variance. Thirty-two percent of the PD patients were classified as apathetic. Apathy was more frequent in patients with dementia. The four apathy dimensions contributed differently to the overall severity of the apathetic condition. Action initiation and intellectual curiosity had a marked influence. Linear regression analysis revealed that the apathy level was mainly determined by cognitive impairment, not associated with the severity of motor symptoms, and only associated with the apathy subcomponent of the Montgomery and Asberg Depression Rating Scale. Apathy is highly prevalent in PD patients. Apathy profiles vary according to the clinical presentation of PD. The high prevalence of apathy in PD suggests the involvement of frontal-subcortical circuits. Although the neurochemical substrate of apathy remains poorly characterized, the strong link between apathy and cognitive impairment observed in several studies suggests the participation of nondopaminergic circuits.     

Cognitive Behavior Therapy for Psychotic Disorders: Current Issues and Future Developments

There is accumulating evidence, reviewed by Caudiano (this issue), that cognitive behavior therapy (CBT) is an effective adjunct treatment for schizophrenia. Schizophrenia treatment and research provides a range of challenges that are probably not present in other mental health problems. These include contextual issues, clinical issues, scientific and methodological issues, practical and pragmatic issues, public concern, and human rights issues. This paper discusses these issues with emphasis on the clinical and research challenges for the future.     

低铁与低热量饮食延缓糖尿病肾病的进展

目的探讨低铁与低热量饮食是否能延缓糖尿病肾病的进展。方法以168例Ⅱ型糖尿病肾病患者为研究对象,随机分为两组,对照组予以常规治疗,治疗组在进行同样常规治疗的同时,予低铁、低热量饮食。结果平均随访37±22个月,治疗组患者血清铁水平显著降低,与对照组比较,有显著差异(P<0.01);治疗组血清肌酐189±78μmmol/L,对照组257±115μmmol/L,两组比较,有显著差异(P<0.01)。治疗组有6例患者达到终止随访目标,血红蛋白低于80g/L和或红细胞压积<33%,需进行促红素治疗,占17.6%;对照组有10例达到终止目标,占35.7%,两组比较,有显著差异(P<0.01)。结论低铁饮食治疗能显著降低糖尿病肾病患者铁负荷,配合低热量饮食治疗,能明显延缓糖尿病肾病的进展。